Liver and Gallbladder Flashcards

1
Q

What plasma proteins does the liver synthesize?

A
  1. albumins
  2. lipoproteins - VLDLs
  3. glycoproteins
  4. prothrombin, fibrinogen
  5. non-immune alpha and beta globulin
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2
Q

What vitamins does the liver store and convert?

A

A, D, K

also iron

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3
Q

What are three metabolic pathways that the liver participates in ?

A
  1. glycogen storage
  2. cholesterol metabolism
  3. urea synthesis
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4
Q

What is the exocrine function of the liver?

A

secretion of bile

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5
Q

What is the endocrine function of the liver?

A

modifies the action of hormones

  • vitamin D
  • thyroxine conversion
  • GHRF - growth hormone releasing factor
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6
Q

What is the dual blood supply of the liver?

A

hepatic portal vein (75%)

  • rich in nutrients, toxins, byproducts
  • depleted of O2
hepatic artery (25%)
-Oxygenated blood which mixes with the venous
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7
Q

What forms a portal triad?

A

portal vein
hepatic artery
interlobular bile duct

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8
Q

Is the portal triad enclosed in glisson’s capsule?

A

yuppp

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9
Q

Describe the flow of blood starting with the portal veins

A
  • -> hepatic sinusoids
  • -> central veins
  • -> sublobular veins
  • -> hepatic veins
  • -> IVC
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10
Q

What do the spaces of Disse lie between?

A

sinusoidal endothelium and the hepatocytes

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11
Q

How would you visual the classic liver lobule in humans?

A

connect the portal canals around the central vein

-central vein is in the center

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12
Q

What does the portal lobule emphasize? How is it drawn?

A

exocrine function of the liver
-portal canal is at the center - bile secretion

  • connect lines btwn three closest central veins
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13
Q

What does the liver acinus provide insight on?

A

blood perfusion

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14
Q

What are the differences in the perfusion of zone 1 vs zone 3

A

zone 1: perilobular

  • most O2
  • dies last and regenerates first

zone 3: centrolobular

  • least O2
  • shows ischemic necrosis first
  • contains glyoclysis enzymes, FA synthesis enzymes
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15
Q

What is special about the hepatic sinusoids?

A

discontinuous, fenestrated

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16
Q

What are kupfer cells?

A

derived from monocytes

  • mononuclear phagocytotic system
  • destroy aged RBCs, digest Hb, destroy bacteria

15% of liver population

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17
Q

What is the function of the perisinusoidal space or space of disse?

A

site of exchange of materials btwn blood and liver cells

18
Q

What are Ito cells?

A

primary storage site for hepatic Vitamin A

19
Q

What happens to Ito cells during cirrhosis?

A

lose ability to store vit A, transform into myofibroblasts and synthesize collagen

results in liver fibrosis

20
Q

What cell makes up 80% of the liver population?

A

hepatocytes

21
Q

Describe the nuclei of a hepatocyte?

A

nuclei are large, spherical, centrally located

  • binucleate cells and polyploid nuclei develop with age
  • adult liver has mostly tetraploid cells
22
Q

What is the life span of a hepatocyte?

A

5 months

23
Q

What type of cell in the liver can be replaced by regeneration after injury?

A

hepatocytes

24
Q

Describe the organelles in the golgi besides the nucleus

A

golgi - can contain as many as 50 units
RER, SER - highly developed
peroxisomes and lysosomes are numerous

25
Q

What happens to newborns with underdeveloped SERs?

A

neonatal hyperbilirubinemia
bilirubin not converted
treated by blue light by fluorescent bulbs

26
Q

What projects into the lumen of a bile canaliculi?

A

small microvilli rich in ATPase, alkaline phosphatase

27
Q

Describe the flow of bile

A

canaliculi -> intrahepatic ductules -> interlobular bile ducts

28
Q

How much bile does the liver secrete a day?

A

1 Liter

29
Q

What does bile consist of?

A

water, phopsholipids, cholesterol, bile salts, bile pigments, electrolytes

30
Q

What percent of bile salts are recycled?

A

90%

31
Q

What provides the color of feces?

A

bilirubin glucorinide

bile pigment from hemoglobin breakdown

32
Q

What three hormones enhance bile secretion?

A

CCK, Gastrin, motilin

33
Q

How much can the gallbladder concentrate bile up to?

A

10 x

34
Q

How many mL of bile can the gallbladder hold?

A

50 mL

35
Q

What cells make up the mucosa of the gallbladder?

A

simple columnar epithelial cells

-specialized fro absorption of electrolytes & h20

36
Q

Does the gallbladder mucosa have a lamina propria or a muscularis mucosae?

A

yes lamina , no muscularis

37
Q

Invaginations of the gallbladder form what ?

A

diverticula or rokitansky-aschoff sinuses

38
Q

What does the invaginations of the gallbladder develop as a result of?

A

age

hyperplasia

39
Q

What is the muscularis of the gallbladder made up of?

A

random smooth muscle bundles

40
Q

Where does the gallbladder have an adventitia, where does it have a serosa?

A

adventitia - attached to liver

serosa - free surface